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Inicio Boletín Médico del Hospital Infantil de México (English Edition) Child care centers and child development in Mexico: progress and challenges
Journal Information
Vol. 74. Issue 2.
Pages 84-85 (March - April 2017)
Vol. 74. Issue 2.
Pages 84-85 (March - April 2017)
DOI: 10.1016/j.bmhime.2017.01.002
Open Access
Child care centers and child development in Mexico: progress and challenges
Estancias infantiles y desarrollo infantil en México: avances y retos
Rafael Pérez-Escamilla
Global Health Concentration, Yale School of Public Health, New Haven, CT, USA
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Early Childhood Development (ECD) is the basis of human and social capital and the development of nations. That is why ECD is a fundamental pillar of the Sustainable Development Goals.1 The recently published Lancet ECD Series indicates that is possible to implement intersectoral ECD evidence-based programs on a large scale.1–4 The evidence clearly shows that these programs should be multifocal, and include health, nutrition, social protection and stimulation and early learning opportunities.1–4 Evidence also points out that these programs must address the needs of the family and the child throughout the life course, from gestation, through early childhood (birth to 5 years), childhood and adolescence, and in adulthood (parents and other caregivers). Due to the high involvement of parents in the workforce, and evidence of the importance of structured early stimulation and early education, care of children in child care facilities during early childhood has become a global priority to promote ECD.3,4 Despite this, little is known about the impact of programs in child care facilities.3

In this issue of the Boletín Médico del Hospital Infantil de México, Rizzoli and colleagues report the results of the impact assessment of ECD programs in childcare facilities operating at large scale in Mexico.5 This study is extremely relevant because it focuses on the PEI (acronym in Spanish) for early child care and education centers, which was created by the Ministry of Social Development (SEDESOL) (acronym in Spanish) a decade ago to support parents or tutors in poverty, who work or study. These programs manage the care of children from 1 to 3 years old. PEI facilities include education and childcare for eight hours a day, five days a week. The PEI is structured as a standardized comprehensive model that includes stimulation, education, health care and nutrition. An advantage of this study is that it was carried out in Baja California and Campeche, two states with different socio-economic, cultural and geographic contexts that reflect the great diversity of the country. A second advantage is that the study has good statistical power since it included 3387 children between 12 and 48 months old who were taken care of in 177 child care facilities. A third strength of the study is that the Multidimensional Child Development Assessment scale was used to measure the impact of PEI on ECD, including fine and gross motor development, and language and social knowledge. This tool was developed and has been widely validated in Mexico by Rizzoli and collaborators,6–13 so its results are robust.

The main finding indicates a positive association between adequate child development and participation for six months or more in PEI, compared to children who were less than one month in the program, regardless of the child's age. I agree with the authors that this finding corroborates the crucial importance of promoting the incorporation of children into childcare programs that include activities to encourage their development from an early age. Although this had already been documented previously in Latin American preschoolers,14 this study demonstrates it in children between one and four years old, which makes it a truly groundbreaking study.

Because the study by Rizzoli et al. is cross-sectional5 it is not only important to confirm the findings with prospective studies, but also to have comparison groups (with similar socio-economic conditions, but not enrolled in study PEI or similar programs). Likewise, it is important to follow designs that allow the identification of the quality of the different components of the PEI that are fundamental to the promotion of the ECD, including nutrition, health, and social protection, as well as stimulation and early education. The lack of qualified personnel to implement effective ECD programs is a challenge that has been identified worldwide.4 For this reason, it is critical that studies are conducted process evaluation and quality control in Mexico to understand the quality and training needs of the educators according to the nurturing care framework of children promulgated by in the Lancet ECD Series published in 2016.2–4 These studies should be done at the national level to maintain not only high coverage but also high-quality child care delivery through the PEI and other government structures. The evidence, summarized in the Lancet ECD Series, clearly indicates that childcare facilities must play a fundamental role in educating and involving parents or tutors in the sensitive and caring care of their children, as well as address “new” challenges such as the childhood obesity epidemic.14

In conclusion, the study by Rizzoli et al.5 as well as the evidence presented in the 2016 Lancet ECD Series,2,4 strongly suggests that based on evidence, progress is being made in Mexico on the issue of ECD in early childhood. However, there is still a long way to go. Human development must be seen as a chain with many links that must be addressed during a lifetime and through different sectors, accordingly with the delivery of high quality standardized multifocal services tailored to the needs of children and their families.2–4 That is why civil society must continue to work hard in a coordinated way to continue strengthening the political will and funding of the government for the benefit of Mexican children in the 21st century.


I dedicate this editorial to Ms. Laura Costas de Labarthe for her more than 50 years of dedication and commitment to the education and development of Mexican girls and boys.

R. Pérez-Escamilla, A. Rizzoli-Córdoba, A. Alonso-Cuevas, R. Reyes-Morales.
Avances en el desarrollo infantil temprano: de neuronas a programas en gran escala.
Bol Med Hosp Infant Mex., 74 (2017), pp. 86-97
M.M. Black, S.P. Walker, L.C.H. Fernald, C.T. Andersen, A.M. DiGirolamo, C. Lu, et al.
Early childhood development coming of age: science through the life course.
P.R. Britto, S.J. Lye, K. Proulx, A.K. Yousafzai, S.G. Matthews, T. Vaivada, et al.
Nurturing care: promoting early childhood development.
L.M. Richter, B. Daelmans, J. Lombardi, J. Heymann, F.L. Boo, J.R. Behrman, et al.
Investing in the foundation of sustainable development: pathways to scale up for early childhood development.
Lancet., 389 (2017), pp. 103-118
A. Rizzoli-Córdoba, L.I. Vargas-Carrillo, R. Vásquez-Ríos, H. Reyes-Morales, M.A. Villasís-Keever, G. O'Shea-Cuevas, et al.
Asociación entre el tiempo de permanencia en el Programa de Estancias Infantiles para niños en situación de pobreza (DIF/SEDESOL) y el nivel de desarrollo infantil.
Bol Med Hosp Infant Mex., 74 (2017), pp. 98-106
A. Rizzoli-Córdoba, L. Schnaas-Arrieta, S. Liendo-Vallejos, G. Buenrostro-Márquez, B. Romo-Pardo, J. Carreón-García, et al.
Validación de un instrumento para la detección oportuna de problemas de desarrollo en menores de 5 años en México.
Bol Med Hosp Infant Mex., 70 (2013), pp. 195-208
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Pasos para transformar una necesidad en una herramienta válida y útil para la detección oportuna de problemas en el desarrollo infantil en México.
Bol Med Hosp Infant Mex., 72 (2015), pp. 420-428
A. Rizzoli-Córdoba, L. Schnaas-Y-Arrieta, F. Ortega-Riosvelasco, E. Rodríguez-Ortega, M.A. Villasís-Keever, D. Aceves-Villagrán, et al.
Child Development Evaluation Test analysis by field improves detection of developmental problems in children.
Bol Med Hosp Infant Mex., 71 (2014), pp. 154-162
A. Rizzoli-Córdoba, F. Ortega-Ríosvelasco, M.A. Villasís-Keever, M. Pizarro-Castellanos, G. Buenrostro-Márquez, D. Aceves-Villagrán, et al.
Confiabilidad de la detección de problemas de desarrollo mediante el semáforo de la prueba de Evaluación del Desarrollo Infantil: ¿es diferente un resultado amarillo de uno rojo?.
Bol Med Hosp Infant Mex., 71 (2014), pp. 277-285
A. Rizzoli-Córdoba, I. Delgado-Ginebra, L.A. Cruz-Ortiz, C.I. Baqueiro-Hernández, I.J. Martain Pérez, J.A. Palma-Tavera, et al.
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Bol Med Hosp Infant Mex., 72 (2015), pp. 376-384
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Diseño de un modelo de supervisión para la aplicación de la prueba de Evaluación del Desarrollo Infantil en las unidades de atención primaria en México.
Bol Med Hosp Infant Mex., 72 (2015), pp. 385-396
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Evaluación diagnóstica del nivel de desarrollo en niños identificados con riesgo de retraso mediante la prueba de Evaluación del Desarrollo Infantil.
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Escrutinio poblacional del nivel de desarrollo infantil en menores de 5 años beneficiarios de PROSPERA en México.
Bol Med Hosp Infant Mex., 72 (2015), pp. 409-419
M.M. Black, R. Pérez-Escamilla, S. Fernandez-Rao.
Integrating nutrition and child development interventions: scientific basis, evidence of impact, and implementation considerations.
Adv Nutr., 6 (2015), pp. 852-859

Please cite this article as: Pérez-Escamilla R. Estancias infantiles y desarrollo infantil en México: avances y retos. Bol Med Hosp Infant Mex. 2017;74:84–85.

Copyright © 2017. Hospital Infantil de México Federico Gómez
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